Suggest the dosage of clozapine and valproate

Respected Dr. XXXXXXX Parakh,
This refers to your answer to my query dated 19/11/13 wherein you had advised my son to be treated with only two medicines, clozapine and valproate. Subsequently you were kind enough to enquire about improvement and behaviour. Tks a lot. Since my son was in a rehab centre in Kerala, we couldn't ask the visiting psychiatrist to change the medicines. Now we have brought him back home. U didn't mention the potency and the number of tabs to be taken daily. For your ready reference, my son presently is being administered T.Chorpromazine 200mg 1-1-2; T.Oxetol 300mg 1-0-1; T. Eptoin 100mg 1-0-2; T.Zypsydon 80mg 1-0-1 and T.Valium 0.5mg 0-0-1. Talking to self continuously and continuous pacing still persists. Once u give the clarification sought for, we shall start administering the medicines as per your advice. Thanks and regards.

Brief Answer:
Prescription online is not legal
Detailed Answer:
Hello,
Thanks for choosing health care magic for posting your query.
I have gone through your question in detail and I can understand what you are going through.
Your son is on two antipsychotics, two anti epileptics and one sedative which is polypharmacy and certainly not the right thing to do. The symptoms of continuous pacing is actually akathesia and the medication that the online doctor suggested , clozapine, is certainly a good option. And valproate is also a good anti epileptic mood stabilizer.
However the clozapine has its own significant side effect of leukocytopenia where in wbc counts fall significantly. This predisposes to infection andcan be fatal as well. Hence it needs to be prescribed strictly under supervision and by regular monitoring of the complete blood count. I my patient i start cpozapine at 12.5 mg at night and gradually increase it to around 350mg under CBC monitoring.
Legally doctors on health care magic are not allowed to prescribe online without physically examining you. Its in the benefit of the patient. You should discuss these drug options with your local psychiatrist who can provide you with a prescription along with the CBC monitoring schedule.
Hope I am able to answer your concerns.
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Wish you good health,
Kind regards
Dr. Srikanth Reddy M.D.